Provider Demographics
NPI:1689210940
Name:PALMERINO, ALFRED SR (RPH)
Entity Type:Individual
Prefix:
First Name:ALFRED
Middle Name:
Last Name:PALMERINO
Suffix:SR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 EUSTIS AVE
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-1547
Mailing Address - Country:US
Mailing Address - Phone:781-245-2543
Mailing Address - Fax:
Practice Address - Street 1:50 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:MA
Practice Address - Zip Code:01833-2407
Practice Address - Country:US
Practice Address - Phone:781-245-2543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-21
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH12654183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist